A design process for a 3D printed patient-specific applicator for HDR brachytherapy of the orbit.

Applicator Brachytherapy High dose-rate Patient-specific

Journal

3D printing in medicine
ISSN: 2365-6271
Titre abrégé: 3D Print Med
Pays: England
ID NLM: 101721758

Informations de publication

Date de publication:
29 Jun 2020
Historique:
received: 11 03 2020
accepted: 15 06 2020
entrez: 1 7 2020
pubmed: 1 7 2020
medline: 1 7 2020
Statut: epublish

Résumé

This report describes a process for designing a 3D printed patient-specific applicator for HDR brachytherapy of the orbit. A 34-year-old man with recurrent melanoma of the orbit was referred for consideration of re-irradiation. An applicator for HDR brachytherapy was designed based on the computed tomography (CT) of patient anatomy. The body contour was used to generate an applicator with a flush fit against the patient's skin while the planning target volume (PTV) was used to devise channels that allow for access and coverage of the tumor bed. An end-to-end dosimetric test was devised to determine feasibility for clinical use. The applicator was designed to conform to the volume and contours inside the orbital cavity. Support wings placed flush with the patient skin provided stability and reproducibility, while 16 source channels of varying length were needed for sufficient access to the target. A solid sheath, printed as an outer support-wall for each channel, prevented bending or accidental puncturing of the surface of the applicator. Quality assurance tests demonstrated feasibility for clinical use. Our experience with available 3D printing technology used to generate an applicator for the orbit may provide guidance for how materials of suitable biomechanical and radiation properties can be used in brachytherapy.

Sections du résumé

BACKGROUND BACKGROUND
This report describes a process for designing a 3D printed patient-specific applicator for HDR brachytherapy of the orbit.
CASE PRESENTATION METHODS
A 34-year-old man with recurrent melanoma of the orbit was referred for consideration of re-irradiation. An applicator for HDR brachytherapy was designed based on the computed tomography (CT) of patient anatomy. The body contour was used to generate an applicator with a flush fit against the patient's skin while the planning target volume (PTV) was used to devise channels that allow for access and coverage of the tumor bed. An end-to-end dosimetric test was devised to determine feasibility for clinical use. The applicator was designed to conform to the volume and contours inside the orbital cavity. Support wings placed flush with the patient skin provided stability and reproducibility, while 16 source channels of varying length were needed for sufficient access to the target. A solid sheath, printed as an outer support-wall for each channel, prevented bending or accidental puncturing of the surface of the applicator.
CONCLUSIONS CONCLUSIONS
Quality assurance tests demonstrated feasibility for clinical use. Our experience with available 3D printing technology used to generate an applicator for the orbit may provide guidance for how materials of suitable biomechanical and radiation properties can be used in brachytherapy.

Identifiants

pubmed: 32601842
doi: 10.1186/s41205-020-00068-3
pii: 10.1186/s41205-020-00068-3
pmc: PMC7322888
doi:

Types de publication

Journal Article

Langues

eng

Pagination

15

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Auteurs

Ergys Subashi (E)

Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. subashie@mskcc.org.

Corbin Jacobs (C)

Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.

Rodney Hood (R)

Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.

David G Kirsch (DG)

Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, USA.

Oana Craciunescu (O)

Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Medical Physics Graduate Program, Duke University Medical Center, Durham, NC, USA.

Classifications MeSH